Authors: Ernest Kurtz
Throughout this period, then, Alcoholics Anonymous grew not only in size but in influence. Although members tended to deny the fellowship’s political and social power, its reality was the necessary result of A.A.’s numerical expansion conjoined with the respect that it increasingly won from professionals and politicians. Much of that respect derived from the fellowship’s steadfast faithfulness to its Traditions of non-involvement, avoiding controversy, and having “no opinion on outside issues.” That, of course, was the ideal: at times individual members, and on at least one notable occasion A.A.’s non-alcoholic trustee-chairman, forgot or found it momentarily impossible to be that self-abnegating. At other times, a kind of ambivalence can be detected in A.A.’s eschewing even the appearance of an influence that realistically could not be gainsaid. Three developments merit brief discussion under this heading: how A.A.’s influence was exercised, members’ ambivalence about some of the results of the program’s increasing acceptance, and the fellowship’s response to the criticisms that increased visibility and power inevitably spawned. Each sheds light on A.A.’s continuing maturation.
As alcoholism became a respectable malady in the larger society, A.A.’s place in that society necessarily changed. Although the Twelve Concepts served to shape more sharply the style of the fellowship’s “trusted servants,” it remained the task of the Twelve Traditions to guide members in the everyday contacts that defined the less formal role of Alcoholics Anonymous. In these efforts, the National Council on Alcoholism proved of invaluable help. Dedicated to education in the widest sense, N.C.A. could do what A.A. could not: publicly seek to guide public perception and policy. That N.C.A., under Marty Mann, was imbued and guided by the Alcoholics Anonymous philosophy was accepted by most as a happy coincidence.
Largely, but at times ambiguously, due to the efforts of the National Council on Alcoholism, a series of 1960s legal decisions led to the decriminalization of alcoholism and its recognition as the nation’s fourth largest public health problem.
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Subsequently, a division of the National Institute of Mental Health addressed itself to alcoholism, pointing the way toward greater direct federal involvement in treatment and research. Treatment pioneers, celebrities, and at least one recovering political figure combined to spearhead an effort that culminated in the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970. The popularly named “Hughes Act” established a separate agency, the National Institute of Alcohol Abuse and Alcoholism (NIAAA), to direct federal efforts, thus giving the rapidly proliferating alcoholism constituency a firm voice in public health planning and research programs.
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The legislation had not emerged out of a vacuum, but it was enacted without input by Alcoholics Anonymous
as
“Alcoholics Anonymous.” A.A.’s impact was nevertheless real and significant, for in a fellowship such as Alcoholics Anonymous, the individual members
are
Alcoholics Anonymous. Many A.A.s, generally very anonymously, had participated mightily in shaping both the content and the direction of the legislation. Despite a myriad of possible pitfalls, the vast majority remained anchored in their Twelve Traditions. Many, indeed, discovered the Traditions’ value under the impact of these events, and it became more common in some parts of the country for “Step Meeting” groups also to hold at least one “Tradition Meeting” a month.
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Yet more important for the present story was an impact of these changes on local Alcoholics Anonymous groups: the need to contend with sometimes vast numbers of not always “bottomed out” newcomers.
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Even before A.A.’s 1974 survey revealed the increasing percentage of members coming to the fellowship by way of treatment, delegates at the 1973 General Service Conference recommended that “The General Service Office of Alcoholics Anonymous, as well as the members of the fellowship, cooperate with agencies dealing with alcoholism — welcoming referrals … and keeping in mind as our primary purpose the welfare of the alcoholic and his recovery.”
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Five years later, negative as well as positive impacts were being noted. Among factors that had “worked to encourage A.A. growth in the past five to seven years,” G.S.O.’s chief of staff noted:
Perhaps the most significant has been the proliferation of rehabilitation programs and treatment centers. Adding to the momentum have been court programs for drunk-driving offenders, industrial programs for employees, and armed services alcoholism programs. With growth have come growing pains. Groups in the vicinity of treatment centers have been inundated with busloads of patients. Young people bring with them other addictions, explicit language, and free discussion of sex. Court-referred drunk-driving offenders want attendance slips signed. These and a thousand other problems have strained A.A. unity and rocked the serenity of many an old-timer.
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Concluding with the observation, “The continuing miracle is that A.A. weathers every storm and flourishes,” Bob P. suggested that the reason for that miracle could be found in A.A.’s Traditions, service structure, and simplicity. All three continued to be challenged by “the profanity problem,” a mere speck on 1973’s horizon. Over the next decade and beyond, expressions of concern multiplied, local Central Service Offices increasingly tendered reminders, and a special ten-page treatment in the January 1987
A.A. Grapevine
attested to the continuing liveliness of the concern. The majority opinion of the fourteen
Grapevine
contributors reflected two earlier General Service Conference answers to Ask-It Basket questions:
(1976) Q. What can be done about the use of four-letter words by our group?
A. Our program clearly states that if you live the program in every area of your life, every area of your life will improve.
(1979) Q. In the past when you went to an A.A. meeting, vulgar language was not allowed. Now when people come from treatment, vulgar language seems the common thing. Is this the “new way,” and how could it be corrected?
A. Experience seems to indicate that this problem eventually solves itself as new members grow in the program. It was pointed out that alcoholics should be allowed to say anything necessary to express themselves.
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Outside criticisms of Alcoholics Anonymous increased after the 1976 publication of the popularly named “Rand Report,” an NIAAA-funded preliminary report of research that seemed to suggest that at least some individuals diagnosed as alcoholics could learn to control their intake of alcohol.
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True to its Traditions, and relying also on the certainty that the National Council on Alcoholism was better equipped to evaluate the NIAAA study, A.A.’s “trusted servants” declined comment — with one noticeable exception. The nonalcoholic chairman of A.A.’s Board of Trustees, Dr. John L. Norris, contacted by a journalist for comment, was interpreted as “repudiating” the report.
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Immediately on the story’s publication, Dr. Norris sought to clarify that he had spoken as a physician who had long personal experience as a pioneer in industrial alcoholism programs rather than as any sort of spokesman for Alcoholics Anonymous. Few A.A. members or others became upset. As similar flaps would demonstrate in succeeding years, few researchers who found “controlled drinking” a viable treatment goal attempted to enlist members of Alcoholics Anonymous in their way of thinking, and A.A. members who chose to comment on that goal tended to limit their expression of concern to how the adduced evidence might affect alcoholics new to recovery.
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Although informal because exercised through the private choices of its individual members who worked in the alcoholism field, A.A.’s clout was nevertheless substantial — or so it seemed to some non-members whose work generally involved research rather than treatment. In March and July 1979, a significant scholarly debate graced the pages of the usually sedate
Journal of Studies on Alcohol
, fomented by Robert E. Tournier’s article “Alcoholics Anonymous as Treatment and as Ideology.” The thrust of Tournier’s piece is well captured by its
Summary
abstract: “It is proposed that Alcoholics Anonymous’s continued domination of the alcoholism treatment field has fettered innovation, precluded early intervention and limited treatment strategies.”
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That A.A. required no extensive defense was clear from several of the “Comments” published in the same issue as Tournier’s original article. The ensuing discussion resulted in general agreement that Alcoholics Anonymous was lay rather than scientific and that although some A.A. members were intolerant and closed-minded, the presence of far larger numbers of adherents to the A.A. “ideology” who were open-minded and tolerant indicated that factors other than membership in Alcoholics Anonymous might better explain the disparity. The term
ideology
of course rankled, but by the 1980s at least some A.A.s were well practiced in humoring the scholarly penchant for substituting academic precision for spiritual concepts such as “way of life.”
Yet the discussion did suggest points that some members of the fellowship and some G.S.O. trusted servants took to heart. Criticisms of A.A.’s “middle-class” orientation were not new, but these now gave impetus to reminders encouraging members to carry the message to low income, less educated alcoholics. A.A. World Services intensified its effort to produce pictorial literature using very simple language, and recent changes in A.A.’s committees on Public Information and Cooperation with the Professional Community seemed ratified.
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Although a direct line cannot be traced, those changes surely flowed in part from the information being garnered by Alcoholics Anonymous from the triennial surveys of its membership that the fellowship began taking in 1968. At the time of the first survey, Dr. John L. Norris, chairman of A.A.’s General Service Board, noted that it was undertaken for two primary reasons: “(1) it will enable the A.A. fellowship to furnish more accurate and scientific data about A.A. and its effectiveness to the growing numbers of professionals — doctors, psychiatrists, social workers, law enforcement officials and others — who are working today in the field of alcoholism; (2) it will provide those of us in A.A. with more information about ourselves and what brought us to A.A. so that we might work even more effectively in carrying the A.A. message to those who still suffer.”
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In 1975 and 1978, Dr. Norris first promulgated the results of the previous year’s surveys to international professional groups. By 1977, however, a shift may be discerned from the prime purpose listed by Norris a decade earlier. At that year’s General Service Conference, the chairman of the Trustees’ Public Information Committee, Walter M., “stated the three-fold purpose of the 1977 survey: (a) to update the findings of previous surveys … and note changes in the composition of the typical A.A. meeting; (b) to provide the public with a realistic appraisal of the effectiveness of A.A. in arresting the disease of alcoholism; (c) to develop a new understanding of the characteristics of the typical member attending an A.A. meeting.”
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The following year, Professor Milton Maxwell succeeded Dr. John Norris as the chairman of A.A.’s trustees, and the surveys from 1980 on have been first reported not to professionals but to A.A. members via
Box 4-5-9
.
The seven surveys conducted between 1968 and 1986 revealed four definite trends. First, between 1968 and 1983, the proportion of women in Alcoholics Anonymous moved from less than one in four to more than one in three. Second, the percentage of those under age thirty meanwhile tripled, from less than 7 percent to more than 20 percent. Third, although a question about dual addiction, dependence on some chemical in addition to alcohol, was added only in 1977, by 1983 the percentage responding affirmatively had almost doubled, from 16 percent to 31 percent. In 1977, 14 percent of the males reported dual addiction, 28 percent of the females; by 1986, those figures had reached 35 percent for the men and 45 percent for the women, for an overall total of 38 percent. Fourth, and finally, the source of referral — how a member came to attend his or her first A.A. meeting — significantly changed. The number of those answering “another A.A. member” declined from 55 percent in 1968 to 37 percent in 1983; those responding “physicians” diminished over the same span from 16 percent to 7 percent. Those replying “counselor” or “treatment center” had meanwhile reached 33 percent by 1980. Although dropping to 31 percent in 1983, this figure rebounded to over 35 percent in 1986, indicating a vast increase from the less than 8 percent total of those answering “counseling agencies” (4%), “hospitals” (2%), “psychologists” (1%), and “social workers” (0.4%) in 1968.
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Comparison of a preliminary impression of the 1986 results with trend indications from 1977 to 1983 confirms that the three factors other than dual addiction are stabilizing at the percentages noted. Women continue to comprise one-third of newcomers; young people (under age 30), between one-fifth and one-fourth. The number of those who attribute first A.A. attendance to an A.A. member meanwhile remains a few percentage points above one-third, while those attending via treatment and counseling have attained almost the same fraction.
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However useful this type of data may be or not be to social scientists and professionals, most A.A. members who are cognizant of the information find in it affirmation of past practice and encouragement to continue their traditional Twelfth-Stepping even in a changed and changing world.
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A time-framing snapshot of the year 1975 affords a useful transition from the topic of A.A.’s
growth
and its corollaries to an examination of how that growth and the changing world influenced A.A.
communication
in the years between 1971 and 1987. Anniversaries celebrate both permanence and change, both unity and diversity, and 1975 witnessed both the silver anniversary meeting of the General Service Conference and A.A.’s fortieth birthday gathering — the first international convention held since Bill W.’s death. Each marked a milestone in the fellowship’s ongoing story.